A 12-year review of Candidaspp. meningitis in patients following neurosurgery
Abstract number: P820
Objective:To review all cases of Candida spp. meningitis in patients following a neurosurgical procedure over a 12 year period in a tertiary care hospital in Dublin, Ireland.
Methods: From September 1998 to July 2009 all cases of Candida spp. meningitis in patients following a neurosurgical procedure were identified using a computer search. A retrospective chart review was performed to analyse patient demographics, outcome, nature of neurosurgical procedure, underlying co-morbidities, species of Candida implicated and type of antifungal agent used for treatment. In addition, time to removal of any neurosurgical device and resolution of infection following isolation of Candida spp. from the cerebrospinal fluid (CSF) was recorded.
Results: Twelve cases of Candida spp. meningitis were identified. The majority of isolates were associated with external ventricular drains (EVDs), one was associated with a lumbar drain and one case followed insertion of Gliadel wafers (a bioploymer wafer to deliver chemotherapy). Candida albicans was the predominant species recovered and amphotericin B the antifungal agent most commonly prescribed. Infection was associated with patients who were on treatment for antecendent bacterial CNS infection and those who underwent multiple EVD or ventriculo-peritoneal shunt revisions. All patients had received broad spectrum antibiotics prior to Candida spp. meningitis. An increase in mortality was seen in those patients who had an underlying malignancy.
Conclusion:Candida spp. neurosurgical infection remains a rare occurrence. Prior antibiotic use, recent or current bacterial CNS infection and multiple neurosurgical device revisions are associated with Candida app. meningitis. An awareness ot these factors may lead to improved management and better outcome in these cases.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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